Detection of causative agents of bacterial pneumonia in hospitalized hajj and umrah cases by multiplex real-time polymerase chain reaction

  • Vivi Setiawaty Research Instalation, National Infectious Diseases Prof. Dr. Sulianti Saroso, Ministry of Health, Jakarta, Indonesia
  • Dini Darmawati Laboratory Division, Faculty of Biology, University of Soedirman, Purwokerto, Indonesia
  • Arie Ardiansyah Nugraha Laboratory Division, Center for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
  • Pancrasia Maria Hendrati Laboratory Division, Faculty of Biology, University of Soedirman, Purwokerto, Indonesia
Keywords: Pneumonia; Multiplex real-time polymerase chain reaction; Bacteria; Hajj and umrah


Background and Objectives: Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is commonly detected in pneumonia patients who travel from the Middle East regions. Besides MERS-CoV, many other pathogenic agents cause pneumonia. Detection of such organisms must be done swiftly, especially in case of the negative MERS-CoV samples. The aim of this study was to identify the pathogenic agents that might account for bacterial pneumonia, from Hajj and Umrah pneumonia cases.

Materials and Methods: We conducted a cross-sectional study, 38 pneumonia clinical samples from suffering of Hajj and Umrah in 2017 with negative MERS-CoV were selected. The laboratory testing was done at National Reference Laboratory in Jakarta and performed by multiplex real-time PCR using a FTD respiratory pathogens.

Results: Haemophilus influenzae (26.4%) was the most frequent bacteria detected. Other causative agents of bacterial pneu- monia identified were Moraxella catarrhalis (20.8%), Klebsiella pneumoniae (13.2%), Streptococcus pneumoniae (9.4%), and Staphylococcus aureus (5.7%). From 38 samples showed that 25 (65.79%) samples were positive with bacteria, in- cluding five samples with coinfection. The coinfection were combinations among S. aureus and S. pneumoniae (1/20), S. pneumoniae and K. pneumoniae (1/20), S. pneumoniae and M. catarrhalis (2/20), S. pneumoniae and H. influenzae (2/20), K. pneumoniae and H. influenzae (5/20), and M. catarrhalis and H. influenzae (5/20).

Conclusion: Haemophilus influenzae is the most recurrent bacteria to be identified in samples of pneumonia of hajj and umrah cases.